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https://www.readbyqxmd.com/read/27875721/percutaneous-mitral-valve-repair-the-last-chance-for-symptoms-improvement-in-advanced-refractory-chronic-heart-failure
#1
Alessandra Berardini, Elena Biagini, Francesco Saia, Davide Stolfo, Mario Previtali, Francesco Grigioni, Bruno Pinamonti, Gabriele Crimi, Alessandro Salvi, Maurizio Ferrario, Antonio De Luca, Fabrizio Gazzoli, Maria Letizia Bacchi Reggiani, Claudia Raineri, Gianfranco Sinagra, Claudio Rapezzi
BACKGROUND: The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS: Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27855469/right-sided-heart-failure-and-extracorporeal-life-support-in-patients-undergoing-pericardiectomy-for-constrictive-pericarditis-a-risk-factor-analysis-for-adverse-outcome
#2
Erik Beckmann, Issam Ismail, Serghei Cebotari, Alexander Busse, Andreas Martens, Malakh Shrestha, Christian Kühn, Axel Haverich, Christine Fegbeutel
Background Right ventricular failure is a life-threatening postoperative complication after pericardiectomy. We conducted a retrospective study with a special emphasis on right ventricular failure. Methods Between June 1997 and September 2011, 69 patients underwent surgical pericardiectomy at our center. Mean age was 59 ( ±  15.5) years, and 49 (71%) patients were male. Causes of constrictive pericarditis included idiopathic (52%, n = 36), tuberculosis (9%, n = 6), postcardiotomy (12%, n = 8), radiation (4%, n = 3), renal insufficiency (12%, n = 8), and autoimmune disease (12%, n = 8)...
November 17, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27834164/efficacy-of-sequential-nephron-blockade-with-intravenous-chlorothiazide-to-promote-diuresis-in-cardiac-intensive-care-infants
#3
Brady S Moffett, Rocky Tsang, Curt Kennedy, Ron A Bronicki, Ayse Akcan-Arikan, Paul A Checchia
BACKGROUND: Sequential nephron blockade using intravenous chlorothiazide is often used to enhance urine output in patients with inadequate response to loop diuretics. A few data exist to support this practice in critically ill infants. METHODS: We included 100 consecutive patients <1 year of age who were administered intravenous chlorothiazide while receiving furosemide therapy in the cardiac ICU in our study. The primary end point was change in urine output 24 hours after chlorothiazide administration, and patients were considered to be responders if an increase in urine output of 0...
November 11, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#4
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27771274/continuous-positive-airway-pressure-versus-oxygen-therapy-in-the-cardiac-surgical-ward-a-randomized-trial
#5
Luigi Olper, Elena Bignami, Ambra L Di Prima, Santina Albini, Simona Nascimbene, Luca Cabrini, Giovanni Landoni, Ottavio Alfieri
BACKGROUND: Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors' aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. DESIGN: Randomized, open-label trial...
August 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27748700/acetazolamide-therapy-for-metabolic-alkalosis-in-pediatric-intensive-care-patients
#6
Carolina López, Andrés José Alcaraz, Blanca Toledo, Lucía Cortejoso, Maite Augusta Gil-Ruiz
OBJECTIVE: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. DESIGN: Retrospective, observational study. SETTING: A tertiary care children's hospital PICU. PATIENTS: Children receiving at least a 2-day course of enteral acetazolamide...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27624603/the-effect-of-tolvaptan-on-renal-excretion-of-electrolytes-and-urea-nitrogen-in-patients-undergoing-coronary-artery-bypass-surgery
#7
Tomoko S Kato, Hiroshi Nakamura, Mai Murata, Kishio Kuroda, Hitoshi Suzuki, Yasutaka Yokoyama, Akie Shimada, Satoshi Matsushita, Taira Yamamoto, Atsushi Amano
BACKGROUND: Adequate fluid management is an important component of patient care following cardiac surgery. Our aim in this study was to determine the benefits of tolvaptan, an oral selective vasopressin-2 receptor antagonist that causes electrolyte-free water diuresis, in postoperative fluid management. We prospectively examined the effect of tolvaptan on renal excretion of electrolytes and urea nitrogen in cardiac surgery patients. METHODS: Patients undergoing coronary artery bypass surgery were randomized to receive conventional loop diuretics (Group C, n = 30) or conventional loop diuretic therapy plus tolvaptan (Group T, n = 27)...
2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27379922/effects-of-short-term-administration-of-tolvaptan-after-open-heart-surgery
#8
Katsuhiko Matsuyama, Nobusato Koizumi, Toshiya Nishibe, Tomoaki Iwasaki, Toru Iwahasi, Kayo Toguchi, Satoshi Takahashi, Akinari Iwahori, Keita Maruno, Hitoshi Ogino
BACKGROUND: Postoperative fluid overload following cardiac surgery is associated with increased morbidity and mortality. Unlike loop diuretics, tolvaptan (TLV) promotes aquaretic effect. Relatively little has been documented regarding the efficacy of TLV after cardiac surgery. The aim of the study was to investigate the effectiveness and safety of tolvaptan for the management of immediately postoperative fluid retention following cardiac surgery. METHODS: Between January to May 2014, patients undergoing cardiac surgery were randomly assigned to control or TLV group immediately after cardiac surgery...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27287597/a-61-year-old-man-with-shortness-of-breath-ascites-and-lower-extremity-edema
#9
Ali Ataya, Jessica M Cope, Diego Moguillansky, Tiago N Machuca, Hassan Alnuaimat
A 61-year-old man presented with an 18-month history of progressive shortness of breath on exertion, fatigue, worsening bilateral lower extremity edema, abdominal swelling, and increased assistance with activities of daily living. Pertinent past medical history included right-sided pneumonia secondary to Streptococcus pneumoniae that was complicated by empyema, requiring right-sided video-assisted thoracoscopic surgery with decortication 2 years earlier. He had a negative cardiac history, no recent travel in the last 3 years, and no known exposure to tuberculosis...
June 2016: Chest
https://www.readbyqxmd.com/read/27110527/comparing-the-effects-of-5-albumin-and-6-hydroxyethyl-starch-130-0-4-voluven-on-renal-function-as-priming-solutions-for-cardiopulmonary-bypass-a-randomized-double-blind-clinical-trial
#10
Mahmood Hosseinzadeh Maleki, Pooya Derakhshan, Amir Rahmanian Sharifabad, Ahmad Amouzeshi
BACKGROUND: The ideal strategy to prime the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery is still a matter of debate. OBJECTIVES: In this retrospective study, we examined Albumin solution and hydroxyethyl starch (HES) for priming the CPB circuit and evaluated the differences in kidney function and bleeding and coagulation status in the two groups of patients. PATIENTS AND METHODS: Sixty consecutive patients undergoing elective coronary artery bypass grafting were studied...
February 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/26961571/clinical-factors-associated-with-dose-of-loop-diuretics-after-pediatric-cardiac-surgery-post-hoc-analysis
#11
Roberta Haiberger, Isabella Favia, Stefano Romagnoli, Paola Cogo, Zaccaria Ricci
A post hoc analysis of a randomized controlled trial comparing the clinical effects of furosemide and ethacrynic acid was conducted. Infants undergoing cardiac surgery with cardiopulmonary bypass were included in order to explore which clinical factors are associated with diuretic dose in infants with congenital heart disease. Overall, 67 patients with median (interquartile range) age of 48 (13-139) days were enrolled. Median diuretic dose was 0.34 (0.25-0.4) mg/kg/h at the end of postoperative day (POD) 0 and it significantly decreased (p = 0...
June 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26895877/-nihilism-of-chronic-heart-failure-therapy-in-children-and-why-effective-therapy-is-withheld
#12
REVIEW
Dietmar Schranz, Norbert F Voelkel
UNLABELLED: Major advances in chronic heart failure (cHF) therapy have been achieved and documented in adult patients, while research regarding the mechanisms and therapy of cHF in children has lagged behind. Based on receptor physiological studies and pharmacological knowledge, treatment with specific ß1-adrenergic receptor blocker (ARB), tissue angiotensin-converting enzyme inhibitor (ACE-I), and mineralocorticoid antagonists have to be recommended in children despite lack of sufficient data derived from prospective randomized studies...
April 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/26874379/variable-contribution-of-heart-failure-to-quality-of-life-in-ambulatory-heart-failure-with-reduced-better-or-preserved-ejection-fraction
#13
Emer Joyce, Christine Chung, Sabrina Badloe, Kayode Odutayo, Akshay Desai, Michael M Givertz, Anju Nohria, Neal K Lakdawala, Garrick C Stewart, Michelle Young, Joanne Weintraub, Lynne W Stevenson, Eldrin F Lewis
OBJECTIVES: The relative contribution of heart failure (HF) compared with other medical and nonmedical factors on diminished quality of life (QOL) across subtypes with reduced, better, and preserved left ventricular ejection fraction (LVEF) in a large ambulatory HF population was evaluated. BACKGROUND: Dominant factors influencing limited QOL in patients with HF have not been investigated. METHODS: Before routine HF clinic visits, 726 patients with ambulatory HF (mean age 56 ± 15 years, 37% women) completed a 1-page questionnaire that assessed QOL and relative contributions of HF compared with other medical and nonmedical factors to their QOL limitations...
March 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/26806504/-uncorrected-tetralogy-of-fallot-a-case-report-of-a-69-year-old-patient
#14
Naďa Hučková, Katarína Sekurisová, Laura Slezáková, Katarína Kusendová, Andrej Zachar, Mária Szántová
Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect. The actual treatment relies on cardio-surgery--complete correction within the infant age. Without surgery only 10% of subjects survived 3rd decade and only 3-5% of subjects were able to survive until their 40th. This particular paper is dedicated to case of a 69-years old male subject with positive history of uncorrected ToF due to his refusal of surgery, ischemic cardiac disease NYHA III-IV and chronic kidney failure. This subject was hospitalized within the department of internal medicine due to several days of chest pain connected with lower extremities oedemas and dyspnoeic syndrome after minimal physical load...
December 2015: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/26750673/conventional-hemofiltration-during-cardiopulmonary-bypass-increases-the-serum-lactate-level-in-adult-cardiac-surgery
#15
Rabie Soliman, Eman Fouad, Makhlouf Belghith, Tarek Abdelmageed
OBJECTIVE: To evaluate the effect of hemofiltration during cardiopulmonary bypass on lactate level in adult patients who underwent cardiac surgery. DESIGN: An observational study. SETTING: Prince Sultan cardiac center, Riyadh, Saudi Arabia. PARTICIPANTS: The study included 283 patients classified into two groups: Hemofiltration group (n=138), hemofiltration was done during CPB. Control group (n = 145), patients without hemofiltration...
January 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/26726710/efficacy-of-tolvaptan-in-patients-with-volume-overload-after-cardiac-surgery
#16
Kenichiro Noguchi, Masashi Tanaka, Ikuo Katayama, Tsuyoshi Yamabe, Daisuke Yuji, Norikazu Oosiro, Miyo Sirouzu
BACKGROUND: The vasopressin type 2 receptor antagonist tolvaptan (TLV) has recently become available for treating congestion. However, there is no evidence confirming the efficacy of TLV for patients with volume overload after cardiac surgery. Here, we retrospectively studied the efficacy of TLV in patients with volume overload after cardiac surgery. METHODS: We enrolled a total of 39 patients who had volume overload after cardiac surgery and who were treated with our protocol of body fluid management...
2015: Heart Surgery Forum
https://www.readbyqxmd.com/read/26687322/hyponatremia-due-to-escitalopram-and-thiazide-use-after-cardiac-surgery
#17
Adem İlkay Diken, Adnan Yalçınkaya, Özlem Erçen Diken, Eray Aksoy, İbrahim Doğan, Seyhan Yılmaz, Kerim Çağlı
Depression and mood disorders occur commonly following emergent cardiac surgery. Selective serotonin reuptake inhibitors are commonly used antidepressants. We report the development of severe hyponatremia leading to adverse clinical effects due to escitalopram and thiazide diuretic use concomitantly in a patient with depression after emergency coronary artery bypass grafting.
February 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/26658199/perioperative-acute-kidney-injury
#18
REVIEW
O Goren, I Matot
Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI...
December 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26583817/-indications-for-surgery-for-valvular-heart-disease
#19
Marcel Halbach, Thorsten Wahlers, Stephan Baldus, Volker Rudolph
Due to the demographic change, chronic valvular heart disease becomes increasingly important - especially age-related primary diseases of the aortic and mitral valve as well as secondary diseases of the mitral and tricuspid valve caused by other age-related cardiac disorders. Medical treatment is limited to symptom relief by use of diuretics. Specific drugs or drugs with a prognostic benefit are not available. Thus, valve repair or replacement are the key options for treatment of relevant valvular heart disease...
November 2015: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/26525900/early-introduction-of-tolvaptan-after-cardiac-surgery-a-renal-sparing-strategy-in-the-light-of-the-renal-resistive-index-measured-by-ultrasound
#20
Tomoko S Kato, Shunya Ono, Kan Kajimoto, Kenji Kuwaki, Taira Yamamoto, Atsushi Amano
BACKGROUND: Renal failure is a serious complication after cardiac surgery, which can be caused by long-term intravenous (IV) loop diuretic use. Tolvaptan is an oral selective vasopressin-2 receptor antagonist used in patients irresponsive to loop diuretics. We investigated their renal perfusion changes using the resistive index (RI) postoperatively. METHODS: Serial renal RI, echocardiography, and laboratory examinations from 14 patients requiring continuous postoperative IV loop diuretics were reviewed...
November 2, 2015: Journal of Cardiothoracic Surgery
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